Efficacy and safety of endoscopic retrograde cholangiopancreatography in recurrent pancreatitis of pediatric asparaginase-associated pancreatitis  

作　　者：Kai-Hua Yang Jing-Qing Zeng Sheng Ding Tian-Ao Zhang Wen-Yu Wang Jia-Yu Zhang Lan Wang Jian Xiao Biao Gong Zhao-Hui Deng 

机构地区：[1]Department of Gastroenterology,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China [2]Department of Gastroenterology,Shanghai Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200120,China

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第10期614-622,共9页世界胃肠内镜杂志（英文版）（电子版）

基　　金：the Science and Technology Commission of Shanghai Municipality of China,No.22Y11921800.

摘　　要：BACKGROUND Asparaginase(ASP)is an important drug in combined chemotherapy regimens for pediatric acute lymphoblastic leukemia(ALL);ASP-associated pancreatitis(AAP)is the main adverse reaction of ASP.Recurrent pancreatitis is a complication of AAP,for which medication is ineffective.AIM To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)in treating recurrent pancreatitis due to AAP.METHODS From May 2018 to August 2021,ten children(five males and five females;age range:4–13 years)with AAP were treated using ERCP due to recurrent pancreatitis.Clinical data of the ten children were collected,including their sex,age,weight,ALL risk grading,clinical symptoms at the onset of pancreatitis,time from the first pancreatitis onset to ERCP,ERCP operation status,and postoperative complications.The symptomatic relief,weight change,and number of pancreatitis onsets before and after ERCP were compared.RESULTS The preoperative symptoms were abdominal pain,vomiting,inability to eat,weight loss of 2-7 kg,and 2-9 pancreatitis onsets.After the operation,nine of ten patients did not develop pancreatitis,had no abdominal pain,could eat normally;the remaining patient developed three pancreatitis onsets due to the continuous administration of ASP,but eating was not affected.The postoperative weight gain was 1.5-8 kg.There was one case of post ERCP pancreatitis and two cases of postoperative infections;all recovered after medication.CONCLUSION ERCP improved clinical symptoms and reduced the incidence of pancreatitis,and was shown to be a safe and effective method for improving the management of recurrent pancreatitis due to AAP.

关 键 词：Acute lymphoblastic leukemia ASPARAGINASE Endoscopic retrograde cholangiopancreatography Pancreatic pseudocyst Recurrent pancreatitis CHILDREN 

分 类 号：R735.9[医药卫生—肿瘤]